(533) Racial disparities in receipt of COVID19 vaccination during pregnancy

COVID19 vaccination is critical to prevent severe infection in pregnancy. There are significant racial disparities in SARS-CoV-2 infection, severe COVID19 disease, and vaccination in the general population. We sought to determine if racial disparities in COVID19 vaccination persist during pregnancy.  

Study Design:

Retrospective cohort study of individuals at a single large tertiary health system who were pregnant or became pregnant and were unvaccinated on or after 4/2021 when the COVID19 vaccine became universally available in our geographic area. Vaccination data are available in the EMR and are linked from State vaccine administration databases, health system clinics, and also reflect manually entered data from clinics. The primary outcome was receipt of COVID19 vaccine dose #1. Patients were followed until receipt of COVID19 vaccine dose #1, delivery, or study end (6/2022). To account for differences in time at risk according to length of gestation, Kaplan Meier survival analysis was used to examine time to receipt of COVID19 vaccine. A multivariate Cox proportional hazards model was built to identify factors associated with receipt of COVID19 vaccination during pregnancy.

Results:

11,519 unvaccinated pregnant persons met inclusion criteria; 1419 (12.8%) received the vaccine during pregnancy. There were significant racial disparities in vaccination, Figure 1. In multivariate analyses, several patient characteristics remained associated with COVID19 vaccination during pregnancy, Table 1. After adjustment for age and comorbidities, Black patients (aHR 0.75, 95% CI 0.65-0.86, p < 0.001) and those who identified as other race (aHR 0.72, 95% CI 0.57-0.91, p=0.006) remained less likely to receive the vaccine during pregnancy compared to White patients.

Conclusion:

Overall COVID19 vaccination rates during pregnancy are low and vary significantly by race. These data could inform public health strategies to improve COVID19 vaccination rates in pregnancy.